Healthcare Provider Details

I. General information

NPI: 1922460997
Provider Name (Legal Business Name): KAMIL ARIF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2016
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2711 IRVIN WAY SUITE 102
DECATUR GA
30030-5405
US

IV. Provider business mailing address

1551 JANMAR RD
SNELLVILLE GA
30078-5606
US

V. Phone/Fax

Practice location:
  • Phone: 678-344-8900
  • Fax:
Mailing address:
  • Phone: 470-579-5600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number91741
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: